File Format:

Microsoft Word - doc

Instructions
The "Request to Conduct DEQ Approved Standard Training Class" form (next page) is for instructors that want to get approved status for standard training that is to be conducted in the future. This form is for classes that are designed to provide the necessary training to pass a DEQ exam and must be taught by a DEQ Approved Instructor. It is available, on the forms page under Operator Certification forms or on the Operator Certification page. This form must be completed and submitted to DEQ prior to a class being conducted to get DEQ training credit. All classes must provide at least 4 hours of training time and more as appropriate for upper level classes. The completed form may be mailed, faxed or e-mailed to me as indicated at the bottom of the form. The form is provided in 2 different formats for your convenience. The Microsoft Word format (.doc) may be submitted by mail or fax (if you print it out and complete it) or e-mail (if you save it as a file, complete it and then attach the file to an e-mail message). The Acrobat PDF format may be printed, completed and mailed or faxed or completed on the computer then printed and mailed or faxed.
Please Note:
• A Request to Conduct DEQ Approved Standard Training Class and Online Exam form must be submitted 6 weeks prior to the class date for each class to be considered for approval.
• Classes shall not be requested earlier than 4 months in advance.
• The Operator Certification Section must be notified in writing if any of the above information changes or cancellation. Emergency changes to the listed instructor must be reported immediately.
• DEQ attendance record forms must be completed and submitted within 10 working days of the first day of class for each approved class.
• DEQ approved classes may be monitored without announcement.
• DEQ approved classes must be primarily classroom-type sessions.
To get training listed in the Main Event Newsletter it must be submitted by the date listed below for each of the three editions:
Training Submission Deadline Edition of the Newsletter
June 1st August
October 1st December
February 1st April
Each class must be submitted with an hourly agenda, a detailed syllabus, completed checklist and a completed correct request form.
Checklist
0 Hourly Agenda
0 Class Syllabus
0 Completed, correct request form
Date of Request: ________________________ Class #: ______________________
Request to Conduct DEQ Approved Standard Training Class and Online Exam
1. Sponsoring Group: ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬-_________________________________________________________________________________
2. Approved Instructor: ______________________________________________Operator License # __________________
Mailing Address (for Attendance Record Forms): _________________________________________________________
City: ____________________________________________________ State: ______ Zip Code: __________________
Telephone # (Work / Home / FAX): _____________________ /______________________ /______________________
E-mail Address: ___________________________________________________________________________________
3. Class Location: ____________________________________________________________________________________
Street Address: _______________________________________________________________________________
City: _________________________________________ State: ______ Zip Code: _________________
4. Is this class OPEN to anyone wishing to take the class? _____Yes _____No
5. Type of Class (check more than 1 if it applies):
_____Class C Distribution & Collection _____Distribution & Collection Technician
_____Class D Water Operator _____Class D Wastewater Operator
_____Class C Water Operator _____Class C Wastewater Operator
_____Class B Water Operator _____Class B Wastewater Operator
_____Class A Water Operator _____Class A Wastewater Operator
_____Class C Water Laboratory Operator _____Class C Wastewater Laboratory Operator
_____Class B Water Laboratory Operator _____Class B Wastewater Laboratory Operator
_____Class A Water Laboratory Operator _____Class A Wastewater Laboratory Operator
Session #1 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #2 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #3 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #4 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #5 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #6 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #7 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #8 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Total Training Hours Requested: ________
6. Expected attendance (for Attendance Record Forms): ________
7. Is an ONLINE EXAM offered? _____Yes Date: ______/______/______ Time_________
Exam Location (If different from the class): ______________________________________________________________
Street Address: ____________________________________________________City_________________________
Cell/Pager # or direct line to classroom where exam is given: __________________________________
ALL STANDARD TRAINING CLASSES AND ASSOCIATED ONLINE EXAM REQUEST FORMS MUST BE SUBMITTED 6 WEEKS PRIOR TO THE FIRST DAY OF THE CLASS.
Mail to: Okla. Dept. of Environmental Quality, Operator Certification, P. O. Box 1677, Oklahoma City, OK 73101-1677 or FAX to: 405-702-8101 or E-MAIL to: mark.kurklin@deq.ok.gov.
Rev. 3/30/11
Class Agenda
For classes longer than two days, this page will need to be filled out and printed more than once.
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
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to
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_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
to

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Instructions
The "Request to Conduct DEQ Approved Standard Training Class" form (next page) is for instructors that want to get approved status for standard training that is to be conducted in the future. This form is for classes that are designed to provide the necessary training to pass a DEQ exam and must be taught by a DEQ Approved Instructor. It is available, on the forms page under Operator Certification forms or on the Operator Certification page. This form must be completed and submitted to DEQ prior to a class being conducted to get DEQ training credit. All classes must provide at least 4 hours of training time and more as appropriate for upper level classes. The completed form may be mailed, faxed or e-mailed to me as indicated at the bottom of the form. The form is provided in 2 different formats for your convenience. The Microsoft Word format (.doc) may be submitted by mail or fax (if you print it out and complete it) or e-mail (if you save it as a file, complete it and then attach the file to an e-mail message). The Acrobat PDF format may be printed, completed and mailed or faxed or completed on the computer then printed and mailed or faxed.
Please Note:
• A Request to Conduct DEQ Approved Standard Training Class and Online Exam form must be submitted 6 weeks prior to the class date for each class to be considered for approval.
• Classes shall not be requested earlier than 4 months in advance.
• The Operator Certification Section must be notified in writing if any of the above information changes or cancellation. Emergency changes to the listed instructor must be reported immediately.
• DEQ attendance record forms must be completed and submitted within 10 working days of the first day of class for each approved class.
• DEQ approved classes may be monitored without announcement.
• DEQ approved classes must be primarily classroom-type sessions.
To get training listed in the Main Event Newsletter it must be submitted by the date listed below for each of the three editions:
Training Submission Deadline Edition of the Newsletter
June 1st August
October 1st December
February 1st April
Each class must be submitted with an hourly agenda, a detailed syllabus, completed checklist and a completed correct request form.
Checklist
0 Hourly Agenda
0 Class Syllabus
0 Completed, correct request form
Date of Request: ________________________ Class #: ______________________
Request to Conduct DEQ Approved Standard Training Class and Online Exam
1. Sponsoring Group: ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬-_________________________________________________________________________________
2. Approved Instructor: ______________________________________________Operator License # __________________
Mailing Address (for Attendance Record Forms): _________________________________________________________
City: ____________________________________________________ State: ______ Zip Code: __________________
Telephone # (Work / Home / FAX): _____________________ /______________________ /______________________
E-mail Address: ___________________________________________________________________________________
3. Class Location: ____________________________________________________________________________________
Street Address: _______________________________________________________________________________
City: _________________________________________ State: ______ Zip Code: _________________
4. Is this class OPEN to anyone wishing to take the class? _____Yes _____No
5. Type of Class (check more than 1 if it applies):
_____Class C Distribution & Collection _____Distribution & Collection Technician
_____Class D Water Operator _____Class D Wastewater Operator
_____Class C Water Operator _____Class C Wastewater Operator
_____Class B Water Operator _____Class B Wastewater Operator
_____Class A Water Operator _____Class A Wastewater Operator
_____Class C Water Laboratory Operator _____Class C Wastewater Laboratory Operator
_____Class B Water Laboratory Operator _____Class B Wastewater Laboratory Operator
_____Class A Water Laboratory Operator _____Class A Wastewater Laboratory Operator
Session #1 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #2 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #3 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #4 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #5 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #6 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #7 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Session #8 Date:______________ Starting Time:__________ Ending Time:__________ # of Hours:______
Total Training Hours Requested: ________
6. Expected attendance (for Attendance Record Forms): ________
7. Is an ONLINE EXAM offered? _____Yes Date: ______/______/______ Time_________
Exam Location (If different from the class): ______________________________________________________________
Street Address: ____________________________________________________City_________________________
Cell/Pager # or direct line to classroom where exam is given: __________________________________
ALL STANDARD TRAINING CLASSES AND ASSOCIATED ONLINE EXAM REQUEST FORMS MUST BE SUBMITTED 6 WEEKS PRIOR TO THE FIRST DAY OF THE CLASS.
Mail to: Okla. Dept. of Environmental Quality, Operator Certification, P. O. Box 1677, Oklahoma City, OK 73101-1677 or FAX to: 405-702-8101 or E-MAIL to: mark.kurklin@deq.ok.gov.
Rev. 3/30/11
Class Agenda
For classes longer than two days, this page will need to be filled out and printed more than once.
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
to